Former Vice President Dick Cheney's heart transplant raises questions about criteria used

By Jed Boal , Deseret News

Published: Tuesday, March 27 2012 3:00 p.m. MDT

In this Aug. 31, 2011 file photo, former Vice President Dick Cheney is interviewed in New York. (Richard Drew, File, Associated Press)

SALT LAKE CITY — More than 3,000 Americans are on the national waiting list for a heart transplant, and hundreds will die this year without receiving the scarce life-extending organ.

Not among them will be former Vice President Dick Cheney, who received a heart transplant last week at 71 years of age, after suffering five heart attacks and fighting heart disease for years.

Among those who are frustrated by the news are those who are still waiting. They are asking the questions about why a patient Cheney's age got a heart and they didn't, speculating whether he received preferential treatment.

Cheney spent 20 months on a waiting list before his successful heart transplant surgery on Saturday — longer than most patients.

A Utah woman said she believes Cheney jumped the line, while her husband was told he was too old for a transplant. "I was really upset. I had 1 million questions flying to my mind. Why, why, why?" said Mary Mahoney. "Why does (Cheney) get it when hundreds of other people in his same age range are told they're not eligible?"

Mahoney said she cannot understand why her husband, Rob, who just turned 73, was told the cutoff age for a transplant was 65. Rob is on a life-saving artificial heart pump and is not on the national organ transplant waiting list.

Mahoney is part of a Facebook group called LVAD Warriors where dozens of other heart patients asked the same questions. One of the posts said, "I can't believe he got a transplant. I guess it's not too surprising; politics as usual."

"How unfair to all the others that are told they're not eligible," another person wrote.

But Dr. David Bull, the chief of cardio-thoracic surgery at the University of Utah Medical Center, was confident there was no way to jump the line, no matter who you are.

"There's not a way to get preferential treatment in the way the system is constructed," he said.

Bull said there's transparency throughout the process. Individual hospitals report to a national database, and the vice president would not have been listed if he was not a good transplant candidate.

Bull also said there's no absolute upper age limit. "It's done on a patient-by-patient basis, so if the treating physicians feel as though the patient is an appropriate candidate, they can be listed," he said.

The fact that Cheney had already suffered five heart attacks moved him up. "The sicker you are, the higher priority you become to receive a heart transplant," Bull said. "The national agencies that oversee this really strive to make the system fair, because they're aware this is a very limited precious resource."

To be placed on the list, doctors at the transplant center consider the person’s medical history, financial situation, including insurance and other resources to pay for the surgery and medications afterward. They also look whether the patient has family and friends to care for and support them.

Mahoney said her husband has come to the conclusion that even if he were eligible, he probably wouldn't accept a new heart. She said he wasn't up for all of the medical follow-ups.

There are currently 113,635 candidates on the waiting list for an organ transplant, according to the Organ Procurement Transplantation Network. Last year, more than 28,500 organ transplants were performed in this country.

UNOS said once added to the national organ transplant waiting list, a person may receive an organ that day or may wait many years. Factors affecting how long a person waits include how well a match that person is with the donor, how sick the person is, and how many donors are available in their local area compared to the number of patients waiting.

More than 325 people die each year waiting for a heart. When a transplant becomes available, doctors check to see who is a good match and in highest medical need. The heart is offered locally, then regionally and finally nationally until a match is made.